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What is the most ridiculous med order you've seen written by a doc in the ER (either an ER doc or an attending planning to admit his pt)? I had a a doc order 2 MG of Dilaudid IVPwith a 2nd dose in 30 min for a broken (mildly) arm. I thought that was a lot...pt was going home, not admitted for surgery or anything.
Hi Christy1019,Yes, I've seen it a few times myself, and the idea is to use it sparingly, because quite rightly, syncope and hypotension is a risk!
And lol at the women mixing up the creams. A bit of an ewww too at that!
I worked with a nurse who, as a new nurse, taped over a pt's orifice applying NTG ointment to a pt's hemorrhoids.
I worked with a nurse who, as a new nurse, taped over a pt's orifice applying NTG ointment to a pt's hemorrhoids.
I've never heard of NTG used for that either. Why would you apply a vasodilator to an already swollen, engorged vessel ? Wouldn't you want something to constrict the vessels?
"Potassium 40 mEq IV push" for a K+ of 3.9. They were going to push it through a 22 g. on the hand of a sweet little octagenerian. I had to have the Pharmacist put a stop to that one because neither the brand new intern (out of Med School two weeks) or the brand new GN (hadn't even taken her boards yet) believed me when I tried to explain what a bad idea it was -- and why.
Was the sweet little octogenarian on Death Row perhaps? Yikes.
Recently had a young 20s heroin OD, given 2mg of Narcan in the field, AOx3 upon arrival to ED. Vitals stable, tachy in the low 100s. He ordered a full work up. Even blood cultures. No medical hx, took no medications, the only abnormal lab result was a potassium of 3.2 (which he ordered nothing for). I gave another 1 mg of Narcan and he made me put her on a Narcan drip -_- He admitted this patient to the ICU. The entire thing was bizarre but fortunately won't be working with that doctor again.
Fentanyl drip ordered to run at 900 mL/hr on a med-surg unit (dying patient). At a concentration of 5 mcg/mL, that equates to 4,500 mcg/hr. I told the doc I wasn't comfortable euthanizing the patient.
Good for you!
OTOH, we have a young SICU patient on a Fentanyl drip at 3600 mcg/hr AND Propofol at 60 mcg/kg/min AND Versed at 24 mg/hour. Not breathing spontaneously, but hypertensive, tachycardic and oxygenating and ventilating with proper support. Wild! Docs won't order paralytics.
Good for you!OTOH, we have a young SICU patient on a Fentanyl drip at 3600 mcg/hr AND Propofol at 60 mcg/kg/min AND Versed at 24 mg/hour. Not breathing spontaneously, but hypertensive, tachycardic and oxygenating and ventilating with proper support. Wild! Docs won't order paralytics.
Whoa!! May I ask why they are in the SICU? That's an insane amount of medication!
This is from a LTC facility: "tonic water 4oz PO PRN per pt request to burp or fart." This was for a LOL who had a bowel obsession and was on at least 4 scheduled stool softener and laxatives and had a fit if she went 12 hours without a "movement." With all those bowel meds, I'd be afraid to fart!
This is from a LTC facility: "tonic water 4oz PO PRN per pt request to burp or fart." This was for a LOL who had a bowel obsession and was on at least 4 scheduled stool softener and laxatives and had a fit if she went 12 hours without a "movement." With all those bowel meds, I'd be afraid to fart!
I'd be afraid to stand behind her...
psu_213, BSN, RN
3,878 Posts
Well, we have all had those days where we were s*** on.